| NPI | 1154525574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ERIC REDMON Owner 540-665-4432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0438000010) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |